Risk of placental abruption in relation to maternal depressive, anxiety and stress symptoms
Risk of placental abruption in relation to maternal depressive, anxiety and stress symptoms
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DOI：
10.1016/j.jad.2010.07.024
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发表时间：
2011-04-01
影响因子：
6.6
通讯作者：
Williams, Michelle A.
中科院分区：
文献类型：
--
作者：
de Paz, Nicole C.;Sanchez, Sixto E.;Williams, Michelle A.
背景资料：关于精神因素对胎盘早剥（PA）病因的影响知之甚少，PA是一种产科疾病，1-2%的妊娠并发症。我们研究了PA的风险与孕产妇的精神症状在pregnancy.Methods：本病例对照研究包括373例PA病例和368例对照在5个医疗中心在利马，秘鲁。采用患者健康问卷（PHQ-9）和抑郁焦虑压力量表（DASS-21）评估抑郁、焦虑和压力症状。多变量logistic回归模型拟合计算比值比（aOR）和95%的置信区间（Cl）调整confronters.Results：抑郁症状的严重程度增加（使用DASS抑郁子量表）与PA（p = 0.02）。与无抑郁症状的女性相比，根据DASS评估，与抑郁症状严重程度水平相关的PA的aOR（95%CI）如下：轻度1.84（0.91-3.74）;中度1.25（0.67-2.33）;重度4.68（0.98-22.4）。根据PHQ评估，轻度、中度和中重度抑郁症状的相应OR分别为1.10（0.79-1.54）、3.31（1.45-7.57）和5.01（1.06-23.6）。一个积极的梯度，观察PA的几率与焦虑的严重程度（p趋势= 0.002）和压力症状（p趋势= 0.002）。局限性：这些横断面收集的数据可能会召回bias.Conclusions：产妇精神疾病可能与AP的发生率增加。更大的研究，允许更精确的评估产妇的精神健康有关PA的风险是必要的。由爱思唯尔公司出版
Background: Little is known about the influence of psychiatric factors on the etiology of placental abruption (PA), an obstetrical condition that complicates 1-2% of pregnancies. We examined the risk of PA in relation to maternal psychiatric symptoms during pregnancy.Methods: This case-control study included 373 PA cases and 368 controls delivered at five medical centers in Lima, Peru. Depressive, anxiety and stress symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and the Depression Anxiety Stress Scales (DASS-21). Multivariable logistic regression models were fit to calculate odds ratios (aOR) and 95% confidence intervals (Cl) adjusted for confounders.Results: Depressive symptoms of increasing severity (using the DASS depression subscale) was associated with PA (p for trend = 0.02). Compared with women with no depressive symptoms, the aOR (95%CI) for PA associated with each level of severity of depression symptoms based on the DASS assessment were as follows: mild 1.84 (0.91-3.74); moderate 1.25 (0.67-2.33); and severe 4.68 (0.98-22.4). The corresponding ORs for mild, moderate, and moderately severe depressive symptoms based on the PHQ assessment were 1.10 (0.79-1.54), 3.31 (1.45-7.57), and 5.01 (1.06-23.6), respectively. A positive gradient was observed for the odds of PA with severity of anxiety (p for trend = 0.002) and stress symptoms (p for trend = 0.002).Limitations: These cross-sectionally collected data may be subject to recall bias.Conclusions: Maternal psychiatric disorders may be associated with an increased occurrence of AP. Larger studies that allow for more precise evaluations of maternal psychiatric health in relation to PA risk are warranted. Published by Elsevier B.V.